الفهرس يوجد فقط 14 صفحة متاحة للعرض العام
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المستخلص
The present essay aims to study apnea in neonates, its pathophysiology, predisposing factors, diagnosis and treatment.
Apnea has been defined most widely as cessation of breathing in excess of 15 seconds duration ,typically accompanied by desaturation and bradycardia.
Apnea is a clinical syndrome that may be attributed to a variety of underlined disorders as prematurity, sepsis, GIT disorders ,neurological disorders, metabolic disorders, temperature instability, maternal drugs and cardiac anomalies.
Apnea in infants may be classified as one of three types:
1- Central apnea is complete cessation of breathing.
2- Obstructive apnea referred to an absence of nasal airflow despite respiratory efforts.
3- Mixed apnea.
Apnea occurs in approximately 25% of preterm infants during the first 10 days of life to those weigh less than 1.8 kg or less than34 weeks gestational age.
The incidence increases with decreasing gestational age.
Several mechanisms have been proposed to explain apnea of prematurity:
1- Immaturity of respiratory center.
2- Decreased sensitivity of chemoreceptors to hypoxia or hypercapnea.
3- Active reflexes invoked by stimulation of the posterior pharynx eg. Vigorous use of suction catheter in the pharynx .
Most cases of apnea are usually detected in infants at high risk. History and physical examination for evaluation of the infant and detection of possible cause of apnea . Routine monitoring for apnea in infants at risk includes heart and respiratory rates as well as oxygen saturation.
Pneumogram may be obtained to determine the frequency and severity of respiratory pauses and a polysomnogram may be used to measure cardiorespiratory pattern, muscular activity, transcutaneous oxygen level, oral or nasal airflow, and chest wall and abdominal movements.
Other tests may be undertaken, depending on infant circumstances ,including EEG, ECG, chest radiograph, CSF analysis, CBC ,ABG,blood glucose , Ca and electrolye level.
Treatment of neonatal apnea includes treatment of the cause.